One World Surgery · Medical Missions Online Donation Form

Medical Mission Trip Fee

*

To pay your own or another volunteer's medical mission fee.

Amount

*

$2,000

$1,000

$500

$250

$

Donation Schedule

Medical Mission Trip Dates

*

If mission trip is not listed, please choose "Other dates" and add information in Special Instructions field below

Individual or Business/Organization

*

Are you making a personal donation as an individual, or on behalf of a business or organization?

Individual

Business/Organization

Business/Organization Name

*

Donor Name

*

Prefix

First Name

Last Name

Suffix

Anonymous

I prefer to remain anonymous in public acknowledgements.

Contact Information

Email

*

Verify Email

*

Phone

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Special Instructions

If you are making this gift in support of a specific medical mission trip participant, enter information here.

Are you an employee of one of the following companies that offers matching gift opportunities?

SCA Health

Optum

Other

Are you interested in attending a future medical mission trip?

Please add me to the Medical Mission interest list.

Keep in touch!

Please add me to the One World Surgery mailing list.

To make a donation by mail, send a check to One World Surgery, 510 Lake Cook Road, Suite 400, Deerfield, IL 60015. To donate by phone call 872-267-3846. For questions or to suspend a recurring donation, contact us at info@oneworldsurgery.org